SURGICAL APPROACHES AND MULTIDISCIPLINARY MANAGEMENT IN THE TREATMENT OF OBSTRUCTIVE SLEEP APNEA

Abstract

This study consists of a narrative literature review aimed at analyzing contemporary scientific evidence regarding surgical approaches and multidisciplinary management in the treatment of Obstructive Sleep Apnea (OSA). OSA is a prevalent chronic respiratory disorder associated with severe cardiovascular morbidities, with continuous positive airway pressure (CPAP) therapy being the gold-standard management for moderate to severe cases, despite its low long-term adherence. Data collection was carried out in the PubMed database using the descriptors “Sleep Apnea, Obstructive” and “Orthognathic Surgery” in articles published within the last five years. The results highlight maxillomandibular advancement (MMA), performed with the assistance of virtual surgical planning (VSP) and CAD/CAM technology, as the key procedure for upper airway expansion and significant reduction of the Apnea-Hypopnea Index (AHI). Although accuracy analyses indicate a small discrepancy between the planned and achieved sagittal movements, the evaluation of patient-reported outcome measures (PROMs) confirms a substantial and stable long-term improvement in subjective quality of life and reduction of daytime sleepiness. Multidisciplinary management is essential, in which the orthodontist plays a central role in screening and referral for definitive diagnosis through polysomnography, with the need for monitoring patients undergoing mandibular setback surgeries due to the risk of inducing OSA.